Table 4.

Distribution of powers in federal or quasi federal states

	Structure	National Responsibility	Regional Responsibility	Summary
Austria	9 regions	Planning and co-ordination Situation monitoring Assessment Communication	Planning and co-ordination Situation monitoring Assessment Communication Overall responsibility for health care Responsibility increases in Phase 5	Regional involvement. Mainly decentralised
Germany	16 regions	Planning and co-ordination Situation monitoring Assessment Communication	Pandemic preparedness Strategic action by health system	Mainly centralised
Spain	17 autonomous regions or communities and 2 autonomous cities	Planning and co-ordination Situation monitoring Assessment Communication Reducing the spread of diseases	Planning and co-ordination Situation monitoring Assessment Communication Reducing the spread of diseases Responsibility increases as of Phase 3	Close involvement of Regional governments co-ordinated by National government
Sweden	21 provinces 290 municipalities	Planning and co-ordination Situation monitoring Assessment Communication Reducing the spread of diseases Guidance for health systems Management of health system Provision of a knowledge base	Planning and co-ordination Reducing the spread of diseases Contingency plans Provision of health care and medical services Distribution of vaccine and antiviral drugs	Mixed - response between National and Regional
United Kingdom*	4 regions	Four national health systems with a national Health Protection Agency Co-ordination and direction Strategy and activation of plan	Delivery Planning Support of National response	Mixed - response between National and Regional

* The rapporteur representing the United Kingdom did not return the completed questionnaire, so questionnaire results do not include information on devolution of powers in the UK. We did however include the UK in our own follow-up research.